There are many insurance companies that offer dental services to seniors. Many are part of the group of insurance companies that fall under Medicare part C. While every insurance company under Medicare Part C offers the same medical coverage as Medicare Part A and Part B, they sometimes offer additional services such as dental coverage. Even so, the types of dental coverages that they offer are not identical.
If you are a senior or are approaching retirement, you may be surprised to find out that Medicare does not provide coverage for routine dental care. Medicare mainly covers medical treatments, but does not provide any assistance for routine dental care such as bi-annual exams, cleanings, or even major services like bridges or dentures. This leaves it to seniors to search for a dental plan that can meet their coverage needs.
Because dental is not included in Original Medicare (unless medically necessary) or Medigap supplement plans, seniors must look elsewhere for dental coverage. So, dental insurance for seniors on Medicare can seem like a chore. But getting dental insurance when you’re using Medicare isn’t difficult, limited, or expensive. In fact, there are two different paths to take in order to find inexpensive coverage options.
*Examples only. These are the average costs the patient will pay per procedure with an in-network provider and are based on averages across Atlanta, Cincinnati, Los Angeles, Manhattan and Saint Louis. Actual costs and savings may vary by provider, geographic area, and service received. There are limitations and exclusions to the discount available. For example, general anesthesia, implants, and/or cosmetic dentistry are not discounted services. Upon purchase, refer to your policy for more information on the limitations and exclusions that apply. Coinsurance listed is for Prime Plan C.
In general the dental insurance companies at the top of our review list provide a range of plan options to numerous areas of the country. We also considered average yearly preventive care costs across numerous zip codes and compared that number to possible yearly premium costs. This helps predict whether the premium costs would, on average, be less than the cost of preventive care paid out of pocket. Keep in mind that co-pays and other small fees might also determine whether you will break even by paying for dental insurance, but our numbers can give you a general idea of what you can expect. It was not surprising to learn that those who charge a higher premium may cover more and those with a lower premium might cover less. This means that if you pay more monthly you might receive more complete coverage, and if you pay less per month you might be expected to pay a bit more during the time of treatment. So you'll need to decide whether you want to pay more per month or make up a bit of the difference when you visit your dentist.
We hoped you learned more about dental insurance for seniors. You have many affordable options. Need assistance or want to learn more? Feel free to contact us or use the form below. We would be happy to help you find an affordable insurance plan for you. Remember, we work in your best interests only. This is the only way we know how to work with our clients. If there is a better plan available that we can’t offer you, we would be happy to help you obtain or recommend that plan to you.
Although discount plans are also sold by private companies, they are not insurance plans. There are no copays, coinsurance, or deductible amounts. That also means that there are no pre-negotiated rates or free yearly checkups and cleanings. A participating dentist simply agrees to offer discounts (often a percentage off from the total price) for certain medical services. Then, seniors who choose discount plans will pay their dentist directly for the cost of services (after the discount).
One example of a plan that is offered through eHealth is the Dominion Dental Services PPO Discount plan which has no deductible. They provide 100% coverage on most preventative and diagnostic procedures and 45% to 60% coverage on all other procedures including children’s orthodontics. They have no maximum annual benefit and they have no waiting period for things like cleaning, extractions, x-rays, and oral surgery but they have waiting periods but you have to use a dentist within their network.
Discount dental plans are not insurance. However they provide a low cost alternative to dental insurance plans. Dental discount plans have a small monthly fee that allows you to receive substantial discounts for procedures with the plans’ In Network dental providers. With discount plans, you only pay the specific discounted amount for the procedures you have. These discounts can be 40-50% off typical retail costs for services. If the cost of care is a significant factor you may want to consider a discount dental plan with a carrier like Careington dental.
Most full coverage dental insurance plans will cover two preventive maintenance visits per year without requiring a deductible payment. Most require a $50 deductible per person, per year to help cover costs beyond your preventive exams. If you need work done, most plans will cover a part of the costs. We looked at root canals specifically and found that the majority of dental plans will cover about half the cost, which may not seem like a lot, but paying half is better than paying upfront for an $800 root canal. However, keep in mind that most insurance policies, depending on your plan, top out at about $1000 to $1500 per year. Using conservative estimates that might be one or two root canals. If you need extensive work done you might have to pay the remaining amount out of pocket.
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Dental Preferred Provider Organization (DPPO) plans: DPPO plans offer you more choice when it comes to dentists. PPO networks include a variety of dentists that agree to treat patients with DPPO insurance at lower rates. Typically, patients with DPPO have to pay a deductible. When seeing a dentist in your DPPO network, you will usually pay a percentage of the lower rate for treatment. Your insurance company will pay for the rest.
Since this is an indemnity plan, you can use other insurances or coverage. A dental discount plan can work well here. Using the above example, if the dentist routinely charges $200 for cleaning, but per the discount plan contract, charges you $100, you will have a net cost of $10. Remember, most discount dental plans charge between $8 and $15 per month depending on other features.
Our top three choices offer an excellent selection of policies and discounts that can protect your savings without requiring you to pay excessive premiums. The companies service almost all markets in the U.S. Remember that you can probably go out of network to see the dentist you prefer, but you will pay more out of pocket for doing so. If you have a favorite dentist, call their office to ask what dental insurances consider them in-network.
Coverage begins at enrollment; there’s no waiting period. All applicants are accepted, even if you have previous dental work or ongoing issues, you’re guaranteed acceptance in the plan. You can even bundle a vision plan with it, for another $14 per month. All rates are guaranteed not to change for at least 12 months, but you can cancel any time you like.
Medicare, the largest health insurance provider for adults 65 and older, does NOT provide coverage for routine dental care. Medicare only pays when dental care and medical needs intersect. Medigap, a private insurance plan that supplements Medicare coverage, doesn’t offer dental coverage, but some private Medicare Advantage managed care plans do offer dental benefits.
If you don’t floss or brush every day, you will likely run into dental problems that everyone is susceptible to, including cavities, gum disease, tooth decay, and enamel erosion. However, there are some dental issues seniors are more at risk for than any other group of people. Seniors can develop these problems even if they properly take care of their teeth.
Since all dental insurance carriers are different, it is important to clarify which dental procedures fall under each specific category. This is important because some insurance plans don't cover major procedures and others have waiting periods for certain procedures. If you know that you will need major dental work that is not covered by a given plan, you should probably look elsewhere to find one that suits all of your needs.
Our health benefit plans, dental plans, vision plans, and life insurance plans have exclusions, limitations, and terms under which the coverage may be continued in force or discontinued. Our dental plans, vision plans, and life insurance plans may also have waiting periods. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker.